Traumatic internal carotid artery aneurysm distant from facial bone fractures treated with a flow diverter stent: A case report

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2025-01-24 DOI:10.1002/ams2.70034

Tatsuya Watanabe, Junzo Nakao, Keishun Boku, Koji Hirata, Yasukazu Totoki, Kuniharu Tasaki, Takeshi Miura, Tetsuya Hoshino, Yukei Matsumoto, Yuki Enomoto, Aiki Marushima, Yuji Matsumaru, Yoshiaki Inoue

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Abstract

Background

Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.

Case Presentation

A 20-year-old woman was admitted following a car accident. Initial contrast-enhanced computed tomography revealed traumatic subarachnoid hemorrhage, a 5-mm internal carotid artery aneurysm, LeFort type I + II, and mandibular fracture. On Day 8, she developed oculomotor palsy, and digital subtraction angiography revealed the aneurysm had increased to 12 mm. She started dual antiplatelet therapy (DAPT) following facial fracture repair. On Day 17, FD was placed, resulting in contrast agent stagnation within the aneurysm. Three months postinjury, her neurological symptoms improved.

Conclusion

Screening for cerebrovascular injury is crucial several days following severe head trauma, even without skull base fractures. Unruptured TICA can be safely treated with FD following DAPT administration.

Abstract Image